| NPI | 1922380294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN PAUL COTTERELL Owner 631-608-5215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NY A188861-1) |
| Enumeration Date | 2011-09-13 |
| Last Update Date | 2011-09-13 |